Obesity as an independent risk factor for decreased survival in node-positive high-risk breast cancer
Obese breast cancer patients have a higher risk of lymph node metastasis and a poorer prognosis compared to patients with normal weight. For obese women with node-positive breast cancer, an association between body weight and prognosis remains unclear. In this retrospective study, we analyzed patien...
Gespeichert in:
| Veröffentlicht in: | Breast cancer research and treatment 2015-06, Vol.151 (3), p.569-576 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 576 |
|---|---|
| container_issue | 3 |
| container_start_page | 569 |
| container_title | Breast cancer research and treatment |
| container_volume | 151 |
| creator | Scholz, Christoph Andergassen, U. Hepp, P. Schindlbeck, C. Friedl, Thomas W. P. Harbeck, N. Kiechle, M. Sommer, H. Hauner, H. Friese, K. Rack, B. Janni, W. |
| description | Obese breast cancer patients have a higher risk of lymph node metastasis and a poorer prognosis compared to patients with normal weight. For obese women with node-positive breast cancer, an association between body weight and prognosis remains unclear. In this retrospective study, we analyzed patient data from the Phase-III ADEBAR trial, in which high-risk breast cancer patients (pT1–4, pN2–3, pM0) were randomized into a docetaxel-based versus epirubicin-based chemotherapy regimen. Patients were grouped according to their BMI value as underweight/normal weight (BMI |
| doi_str_mv | 10.1007/s10549-015-3422-3 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1897373519</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A435606871</galeid><sourcerecordid>A435606871</sourcerecordid><originalsourceid>FETCH-LOGICAL-c573t-980ae3def5c337c71cada3ea6d48a6625136f9a50d295d218f6e98bdb09fd4df3</originalsourceid><addsrcrecordid>eNqFkl1rFDEYhQdR7Fr9Ad5IQBBvUvMxSSaXpfgFhd7odcgmb3ZTZ5M1mVnov2_GrdqKIiEJJM85vAdO172k5IwSot5VSkSvMaEC854xzB91KyoUx4pR9bhbESoVlgORJ92zWq8JIVoR_bQ7YUJLJnW_6uBqDTVON8hWZBOKycMe2pEmVGL9hoJ1Uy4otO3BFbAVPKpzOcSDHRuOUvaA97l5xAOgbdxs8Q_hemEn5GxyUJ53T4IdK7y4u0-7rx_ef7n4hC-vPn6-OL_Erk09YT0QC9xDEI5z5RR11lsOVvp-sFIyQbkM2grimRae0SFI0MPar4kOvveBn3Zvj777kr_PUCezi9XBONoEea6GDlpxxQXV_0flIIkiQrOGvv4Dvc5zSS3IQrWhdE_ob2pjRzAxhTwV6xZTc95zIYkc1EKd_YVqy8MuupwgxPb-QPDmnmALdpy2NY_zFHOqD0F6BF3JtRYIZl_izpYbQ4lZ6mKOdTGtLmapi-FN8-ou2bzegf-l-NmPBrAjUNtX2kC5F_2frrc9Fcg4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1685139401</pqid></control><display><type>article</type><title>Obesity as an independent risk factor for decreased survival in node-positive high-risk breast cancer</title><source>MEDLINE</source><source>Springer Online Journals Complete</source><creator>Scholz, Christoph ; Andergassen, U. ; Hepp, P. ; Schindlbeck, C. ; Friedl, Thomas W. P. ; Harbeck, N. ; Kiechle, M. ; Sommer, H. ; Hauner, H. ; Friese, K. ; Rack, B. ; Janni, W.</creator><creatorcontrib>Scholz, Christoph ; Andergassen, U. ; Hepp, P. ; Schindlbeck, C. ; Friedl, Thomas W. P. ; Harbeck, N. ; Kiechle, M. ; Sommer, H. ; Hauner, H. ; Friese, K. ; Rack, B. ; Janni, W.</creatorcontrib><description>Obese breast cancer patients have a higher risk of lymph node metastasis and a poorer prognosis compared to patients with normal weight. For obese women with node-positive breast cancer, an association between body weight and prognosis remains unclear. In this retrospective study, we analyzed patient data from the Phase-III ADEBAR trial, in which high-risk breast cancer patients (pT1–4, pN2–3, pM0) were randomized into a docetaxel-based versus epirubicin-based chemotherapy regimen. Patients were grouped according to their BMI value as underweight/normal weight (BMI < 25 kg/m
2
;
n
= 543), overweight (BMI 25–29.9 kg/m
2
;
n
= 482) or obese (BMI ≥ 30 kg/m
2
;
n
= 285). Overweight and obese patients were older, had larger tumors and were more likely to be postmenopausal at the time of diagnosis compared to underweight/normal-weight patients (all
p
< 0.001). Multivariate Cox regression analyses adjusting for age and histopathological tumor features showed that obese patients had a significantly shorter disease-free survival (DFS; HR 1.43; 95 % CI 1.11–1.86;
p
= 0.006) and overall survival (OS; HR 1.56; 95 % CI 1.14–2.14;
p
= 0.006) than non-obese patients. Subgroup analyses revealed that the differences in DFS and OS were significant for postmenopausal but not for premenopausal patients, and that the survival benefit of non-obese patients was more pronounced in women with hormone-receptor-positive disease. Obesity constitutes an independent, adverse prognostic factor in high-risk node-positive breast cancer patients, in particular for postmenopausal women and women with hormone-receptor-positive disease.</description><identifier>ISSN: 0167-6806</identifier><identifier>EISSN: 1573-7217</identifier><identifier>DOI: 10.1007/s10549-015-3422-3</identifier><identifier>PMID: 25962694</identifier><identifier>CODEN: BCTRD6</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Anthracyclines ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biomarkers, Tumor ; Body Mass Index ; Body weight ; Breast cancer ; Breast Neoplasms - complications ; Breast Neoplasms - drug therapy ; Breast Neoplasms - mortality ; Breast Neoplasms - pathology ; Cancer patients ; Cancer research ; Cancer therapies ; Chemotherapy ; Clinical Trial ; Clinical Trials, Phase III as Topic ; Female ; Health aspects ; Humans ; Kaplan-Meier Estimate ; Lymphatic Metastasis ; Lymphatic system ; Medical prognosis ; Medicine ; Medicine & Public Health ; Menopause ; Metastasis ; Neoplasm Staging ; Obesity ; Obesity - complications ; Oncology ; Postmenopausal women ; Prognosis ; Randomized Controlled Trials as Topic ; Retrospective Studies ; Risk Factors</subject><ispartof>Breast cancer research and treatment, 2015-06, Vol.151 (3), p.569-576</ispartof><rights>Springer Science+Business Media New York 2015</rights><rights>COPYRIGHT 2015 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c573t-980ae3def5c337c71cada3ea6d48a6625136f9a50d295d218f6e98bdb09fd4df3</citedby><cites>FETCH-LOGICAL-c573t-980ae3def5c337c71cada3ea6d48a6625136f9a50d295d218f6e98bdb09fd4df3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10549-015-3422-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10549-015-3422-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25962694$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Scholz, Christoph</creatorcontrib><creatorcontrib>Andergassen, U.</creatorcontrib><creatorcontrib>Hepp, P.</creatorcontrib><creatorcontrib>Schindlbeck, C.</creatorcontrib><creatorcontrib>Friedl, Thomas W. P.</creatorcontrib><creatorcontrib>Harbeck, N.</creatorcontrib><creatorcontrib>Kiechle, M.</creatorcontrib><creatorcontrib>Sommer, H.</creatorcontrib><creatorcontrib>Hauner, H.</creatorcontrib><creatorcontrib>Friese, K.</creatorcontrib><creatorcontrib>Rack, B.</creatorcontrib><creatorcontrib>Janni, W.</creatorcontrib><title>Obesity as an independent risk factor for decreased survival in node-positive high-risk breast cancer</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><addtitle>Breast Cancer Res Treat</addtitle><description>Obese breast cancer patients have a higher risk of lymph node metastasis and a poorer prognosis compared to patients with normal weight. For obese women with node-positive breast cancer, an association between body weight and prognosis remains unclear. In this retrospective study, we analyzed patient data from the Phase-III ADEBAR trial, in which high-risk breast cancer patients (pT1–4, pN2–3, pM0) were randomized into a docetaxel-based versus epirubicin-based chemotherapy regimen. Patients were grouped according to their BMI value as underweight/normal weight (BMI < 25 kg/m
2
;
n
= 543), overweight (BMI 25–29.9 kg/m
2
;
n
= 482) or obese (BMI ≥ 30 kg/m
2
;
n
= 285). Overweight and obese patients were older, had larger tumors and were more likely to be postmenopausal at the time of diagnosis compared to underweight/normal-weight patients (all
p
< 0.001). Multivariate Cox regression analyses adjusting for age and histopathological tumor features showed that obese patients had a significantly shorter disease-free survival (DFS; HR 1.43; 95 % CI 1.11–1.86;
p
= 0.006) and overall survival (OS; HR 1.56; 95 % CI 1.14–2.14;
p
= 0.006) than non-obese patients. Subgroup analyses revealed that the differences in DFS and OS were significant for postmenopausal but not for premenopausal patients, and that the survival benefit of non-obese patients was more pronounced in women with hormone-receptor-positive disease. Obesity constitutes an independent, adverse prognostic factor in high-risk node-positive breast cancer patients, in particular for postmenopausal women and women with hormone-receptor-positive disease.</description><subject>Anthracyclines</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Biomarkers, Tumor</subject><subject>Body Mass Index</subject><subject>Body weight</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - complications</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - mortality</subject><subject>Breast Neoplasms - pathology</subject><subject>Cancer patients</subject><subject>Cancer research</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Clinical Trial</subject><subject>Clinical Trials, Phase III as Topic</subject><subject>Female</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Lymphatic Metastasis</subject><subject>Lymphatic system</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Menopause</subject><subject>Metastasis</subject><subject>Neoplasm Staging</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Oncology</subject><subject>Postmenopausal women</subject><subject>Prognosis</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><issn>0167-6806</issn><issn>1573-7217</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkl1rFDEYhQdR7Fr9Ad5IQBBvUvMxSSaXpfgFhd7odcgmb3ZTZ5M1mVnov2_GrdqKIiEJJM85vAdO172k5IwSot5VSkSvMaEC854xzB91KyoUx4pR9bhbESoVlgORJ92zWq8JIVoR_bQ7YUJLJnW_6uBqDTVON8hWZBOKycMe2pEmVGL9hoJ1Uy4otO3BFbAVPKpzOcSDHRuOUvaA97l5xAOgbdxs8Q_hemEn5GxyUJ53T4IdK7y4u0-7rx_ef7n4hC-vPn6-OL_Erk09YT0QC9xDEI5z5RR11lsOVvp-sFIyQbkM2grimRae0SFI0MPar4kOvveBn3Zvj777kr_PUCezi9XBONoEea6GDlpxxQXV_0flIIkiQrOGvv4Dvc5zSS3IQrWhdE_ob2pjRzAxhTwV6xZTc95zIYkc1EKd_YVqy8MuupwgxPb-QPDmnmALdpy2NY_zFHOqD0F6BF3JtRYIZl_izpYbQ4lZ6mKOdTGtLmapi-FN8-ou2bzegf-l-NmPBrAjUNtX2kC5F_2frrc9Fcg4</recordid><startdate>20150601</startdate><enddate>20150601</enddate><creator>Scholz, Christoph</creator><creator>Andergassen, U.</creator><creator>Hepp, P.</creator><creator>Schindlbeck, C.</creator><creator>Friedl, Thomas W. P.</creator><creator>Harbeck, N.</creator><creator>Kiechle, M.</creator><creator>Sommer, H.</creator><creator>Hauner, H.</creator><creator>Friese, K.</creator><creator>Rack, B.</creator><creator>Janni, W.</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>7TS</scope></search><sort><creationdate>20150601</creationdate><title>Obesity as an independent risk factor for decreased survival in node-positive high-risk breast cancer</title><author>Scholz, Christoph ; Andergassen, U. ; Hepp, P. ; Schindlbeck, C. ; Friedl, Thomas W. P. ; Harbeck, N. ; Kiechle, M. ; Sommer, H. ; Hauner, H. ; Friese, K. ; Rack, B. ; Janni, W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c573t-980ae3def5c337c71cada3ea6d48a6625136f9a50d295d218f6e98bdb09fd4df3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Anthracyclines</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Biomarkers, Tumor</topic><topic>Body Mass Index</topic><topic>Body weight</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - complications</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Breast Neoplasms - mortality</topic><topic>Breast Neoplasms - pathology</topic><topic>Cancer patients</topic><topic>Cancer research</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Clinical Trial</topic><topic>Clinical Trials, Phase III as Topic</topic><topic>Female</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Lymphatic Metastasis</topic><topic>Lymphatic system</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Menopause</topic><topic>Metastasis</topic><topic>Neoplasm Staging</topic><topic>Obesity</topic><topic>Obesity - complications</topic><topic>Oncology</topic><topic>Postmenopausal women</topic><topic>Prognosis</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Scholz, Christoph</creatorcontrib><creatorcontrib>Andergassen, U.</creatorcontrib><creatorcontrib>Hepp, P.</creatorcontrib><creatorcontrib>Schindlbeck, C.</creatorcontrib><creatorcontrib>Friedl, Thomas W. P.</creatorcontrib><creatorcontrib>Harbeck, N.</creatorcontrib><creatorcontrib>Kiechle, M.</creatorcontrib><creatorcontrib>Sommer, H.</creatorcontrib><creatorcontrib>Hauner, H.</creatorcontrib><creatorcontrib>Friese, K.</creatorcontrib><creatorcontrib>Rack, B.</creatorcontrib><creatorcontrib>Janni, W.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Physical Education Index</collection><jtitle>Breast cancer research and treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Scholz, Christoph</au><au>Andergassen, U.</au><au>Hepp, P.</au><au>Schindlbeck, C.</au><au>Friedl, Thomas W. P.</au><au>Harbeck, N.</au><au>Kiechle, M.</au><au>Sommer, H.</au><au>Hauner, H.</au><au>Friese, K.</au><au>Rack, B.</au><au>Janni, W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Obesity as an independent risk factor for decreased survival in node-positive high-risk breast cancer</atitle><jtitle>Breast cancer research and treatment</jtitle><stitle>Breast Cancer Res Treat</stitle><addtitle>Breast Cancer Res Treat</addtitle><date>2015-06-01</date><risdate>2015</risdate><volume>151</volume><issue>3</issue><spage>569</spage><epage>576</epage><pages>569-576</pages><issn>0167-6806</issn><eissn>1573-7217</eissn><coden>BCTRD6</coden><abstract>Obese breast cancer patients have a higher risk of lymph node metastasis and a poorer prognosis compared to patients with normal weight. For obese women with node-positive breast cancer, an association between body weight and prognosis remains unclear. In this retrospective study, we analyzed patient data from the Phase-III ADEBAR trial, in which high-risk breast cancer patients (pT1–4, pN2–3, pM0) were randomized into a docetaxel-based versus epirubicin-based chemotherapy regimen. Patients were grouped according to their BMI value as underweight/normal weight (BMI < 25 kg/m
2
;
n
= 543), overweight (BMI 25–29.9 kg/m
2
;
n
= 482) or obese (BMI ≥ 30 kg/m
2
;
n
= 285). Overweight and obese patients were older, had larger tumors and were more likely to be postmenopausal at the time of diagnosis compared to underweight/normal-weight patients (all
p
< 0.001). Multivariate Cox regression analyses adjusting for age and histopathological tumor features showed that obese patients had a significantly shorter disease-free survival (DFS; HR 1.43; 95 % CI 1.11–1.86;
p
= 0.006) and overall survival (OS; HR 1.56; 95 % CI 1.14–2.14;
p
= 0.006) than non-obese patients. Subgroup analyses revealed that the differences in DFS and OS were significant for postmenopausal but not for premenopausal patients, and that the survival benefit of non-obese patients was more pronounced in women with hormone-receptor-positive disease. Obesity constitutes an independent, adverse prognostic factor in high-risk node-positive breast cancer patients, in particular for postmenopausal women and women with hormone-receptor-positive disease.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>25962694</pmid><doi>10.1007/s10549-015-3422-3</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0167-6806 |
| ispartof | Breast cancer research and treatment, 2015-06, Vol.151 (3), p.569-576 |
| issn | 0167-6806 1573-7217 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1897373519 |
| source | MEDLINE; Springer Online Journals Complete |
| subjects | Anthracyclines Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biomarkers, Tumor Body Mass Index Body weight Breast cancer Breast Neoplasms - complications Breast Neoplasms - drug therapy Breast Neoplasms - mortality Breast Neoplasms - pathology Cancer patients Cancer research Cancer therapies Chemotherapy Clinical Trial Clinical Trials, Phase III as Topic Female Health aspects Humans Kaplan-Meier Estimate Lymphatic Metastasis Lymphatic system Medical prognosis Medicine Medicine & Public Health Menopause Metastasis Neoplasm Staging Obesity Obesity - complications Oncology Postmenopausal women Prognosis Randomized Controlled Trials as Topic Retrospective Studies Risk Factors |
| title | Obesity as an independent risk factor for decreased survival in node-positive high-risk breast cancer |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-08T04%3A19%3A39IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Obesity%20as%20an%20independent%20risk%20factor%20for%20decreased%20survival%20in%20node-positive%20high-risk%20breast%20cancer&rft.jtitle=Breast%20cancer%20research%20and%20treatment&rft.au=Scholz,%20Christoph&rft.date=2015-06-01&rft.volume=151&rft.issue=3&rft.spage=569&rft.epage=576&rft.pages=569-576&rft.issn=0167-6806&rft.eissn=1573-7217&rft.coden=BCTRD6&rft_id=info:doi/10.1007/s10549-015-3422-3&rft_dat=%3Cgale_proqu%3EA435606871%3C/gale_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1685139401&rft_id=info:pmid/25962694&rft_galeid=A435606871&rfr_iscdi=true |